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Related Experiment Videos

Cost methodology of COMBINE.

Gary A Zarkin1, Jeremy W Bray, Debanjali Mitra

  • 1RTI International, 3040 Cornwallis Road, Research Triangle Park, North Carolina 27709, USA. gaz@rti.org

Journal of Studies on Alcohol. Supplement
|October 15, 2005
PubMed
Summary

This study outlines a cost estimation methodology for alcohol dependence treatments in the COMBINE randomized controlled trial (RCT). The approach details costs for non-research activities, staff time, and patient time, identifying key cost drivers for interventions like Medical Management (MM) and Combined Behavioral Intervention (CBI).

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Area of Science:

  • Health Economics
  • Clinical Trial Methodology
  • Substance Abuse Treatment

Background:

  • Estimating the cost-effectiveness of treatments is crucial for healthcare decision-making.
  • The COMBINE randomized controlled trial (RCT) evaluated pharmacotherapies and behavioral interventions for alcohol dependence.
  • Previous cost estimation methods may lack the detail required for comprehensive analysis of complex interventions.

Purpose of the Study:

  • To describe a novel methodology for estimating the mean cost per patient of interventions delivered in the COMBINE RCT.
  • To identify and quantify all non-research activities essential for implementing COMBINE interventions in standard clinical practice.
  • To estimate both provider and patient costs associated with these interventions.

Main Methods:

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  • A comprehensive list of non-research activities was identified for standard clinical practice implementation.
  • Costs were estimated for staff time (clinical assessments, interventions), space, laboratory charges, and medical supplies.
  • Patient time associated with each activity was also quantified.

Main Results:

  • Estimated costs per activity were presented for 15 intake assessments and Medical Management (MM) and Combined Behavioral Intervention (CBI) sessions.
  • Labor costs constituted the majority of the total cost across all activities.
  • The Form 90 AIR/ED intake activity was the most expensive; CBI sessions incurred higher costs than MM sessions.

Conclusions:

  • The developed methodology provides a robust framework for estimating the costs of implementing interventions like those in COMBINE.
  • The prospective design and detailed activity costing offer higher quality data and identify key cost drivers compared to previous methods.
  • The methodology's concepts and instruments are adaptable for cost studies in other randomized controlled trials (RCTs).